Toothbrush Abrasion: Preventing Tooth Destruction

The Cause

Brushing improperly (especially with a hard-bristled toothbrush) can cause erosion/abrasion of your tooth or teeth. This is a very common problem. It begins as a small V- or U-shaped area of wear near the gingival (gum) tissue right next to the tooth, usually where the tooth and gum meet. Improper brushing causes the gum tissue to recede; and the tooth may become sensitive to heat, cold, or air stimulation. With time, more enamel wears away and a small horizontal notch is seen on the tooth at the gumline. This is not an area of decay, but a mechanical “cavity” cut in the tooth. Eventually the enamel is worn completely through and the dentin becomes exposed. When that occurs, some people experience severe tooth sensitivity. It may be so severe that it is painful to drink cold fluids, breathe in air, or just brush your teeth. However, others experience little to no extra tooth sensitivity.

Once enough of the gum is brushed away, the root of the tooth becomes exposed. The root surface is not covered with enamel and is much softer than the enamel. It can also be unsightly to have the tissue recede. Since the root surface is not protected by hard enamel, if the improper brushing continues, the root cementum will be worn through and notch will be made in the dentin. This notch will increase in size, weaken the tooth, and sometimes make the area more prone to decay.

Tooth Sensitivity  

Some patients with little loss of tooth structure experience extreme sensitivity. This problem can usually be corrected with the application of a dentin-bonding material or other desensitizing chemicals. The sensitivity problem is often completely cured. The treatment can last (depending on your brushing habits) for 6 months or longer. If necessary, the tooth can be re-treated if the sensitivity returns.

Some patients with a tremendous loss of tooth structure notice little tooth sensitivity. Whether or not the teeth become sensitive, it is advisable to correct the brushing problem to slow down or eliminate the wear process. It is also recommended that the notches be restored with a tooth-colored filling material. This will restore the appearance of the tooth and protect the previously exposed dentin. In this way, even if you continue to brush improperly, the tooth will be protected.

In cases of minor sensitivity, we might recommend the use of desensitizing toothpaste as a low-cost alternative to the placement of bonded materials. Some cases might also be managed through the use of topical fluoride applicants.

Preventing Abrasion

The problems of improper toothbrushing are easily and inexpensively corrected when they are diagnosed in the early stages of development. If allowed to progress, the tooth damage will increase, as the cost to repair it. The best solution is prevention!

Brush your teeth thoroughly but not abusively. Do not scrub them or cross brush them (an exaggerated horizontal brushing motion). We will select a method of toothbrushing that will best meet your needs and teach you to care for your mouth. Use a soft toothbrush. Change to a new tooth brush every 3 months. But if it happens that you are creating the problem of toothbrush abrasion, get it corrected as soon as it is diagnosed.